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The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
11248 Results
5604
Integration of mental health/substance abuse and primary care
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: OBJECTIVES: To describe models of integrated care used in the United States, assess how integration of mental health services into primary care settings or primary health care into specialty outpatient settings impacts patient outcomes and describe barriers to sustainable programs, use of health information technology (IT), and reimbursement structures of integrated care programs within the United States. DATA SOURCES: MEDLINE, CINAHL, Cochrane databases, and PsychINFO databases, the internet, and expert consultants for relevant trials and other literature that does not traditionally appear in peer reviewed journals. REVIEW METHODS: Randomized controlled trials and high quality quasi-experimental design studies were reviewed for integrated care model design components. For trials of mental health services in primary care settings, levels of integration codes were constructed and assigned for provider integration, integrated processes of care, and their interaction. Forest plots of patient symptom severity, treatment response, and remission were constructed to examine associations between level of integration and outcomes. RESULTS: Integrated care programs have been tested for depression, anxiety, at-risk alcohol, and ADHD in primary care settings and for alcohol disorders and persons with severe mental illness in specialty care settings. Although most interventions in either setting are effective, there is no discernible effect of integration level, processes of care, or combination, on patient outcomes for mental health services in primary care settings. Organizational and financial barriers persist to successfully implement sustainable integrated care programs. Health IT remains a mostly undocumented but promising tool. No reimbursement system has been subjected to experiment; no evidence exists as to which reimbursement system may most effectively support integrated care. Case studies will add to our understanding of their implementation and sustainability. CONCLUSIONS: In general, integrated care achieved positive outcomes. However, it is not possible to distinguish the effects of increased attention to mental health problems from the effects of specific strategies, evidenced by the lack of correlation between measures of integration or a systematic approach to care processes and the various outcomes. Efforts to implement integrated care will have to address financial barriers. There is a reasonably strong body of evidence to encourage integrated care, at least for depression. Encouragement can include removing obstacles, creating incentives, or mandating integrated care. Encouragement will likely differ between fee-for-service care and managed care. However, without evidence for a clearly superior model, there is legitimate reason to worry about premature orthodoxy.
Topic(s):
Financing & Sustainability
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, Key & Foundational
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Reference Links: View the PubMed citation for Integration of mental health/substance abuse and primary care
5606
Integration of Neuropsychological Services in a VA HIV Primary Care Clinic
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: The Department of Veteran Affairs (VA) is the largest health care provider for individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), with >28,000 Veterans with HIV/AIDS enrolled in care. Advances in medical treatment have improved the life-limiting effects of the disease, though many chronic symptoms persist. Comprehensive care is critical to manage the diverse constellation of symptoms. However, many patients face challenges to receiving optimal care due to limited resources, mistrust of health care providers, and/or co-occurring medical, psychiatric, and substance use disorders. The VA is a leader in developing integrated models of care to address these barriers. The inclusion of subspecialty mental health and substance abuse treatment in HIV care has been implemented across many VAs, with evidence of improved patient outcomes. However, neuropsychology has not traditionally been included, despite the fact that cognitive dysfunction represents one of the most ubiquitous complications of HIV/AIDS. Cognitive impairment is associated with myriad negative outcomes including medication non-adherence, reduced quality of life, and increased mortality. We contend that neuropsychologists are uniquely equipped to contribute to the comprehensive care of patients with HIV/AIDS. Neuropsychologists understand the range of factors that can impact cognition and have the requisite knowledge and skills to assess and treat cognitive dysfunction. Although we focus on HIV/AIDS, neuropsychologists often play critical roles in the provision of care for other infectious diseases (e.g., hepatitis C).
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Integration of Neuropsychological Services in a VA HIV Primary Care Clinic
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View the PubMed citation for Integration of Neuropsychological Services in a VA HIV Primary Care Clinic5607
Integration of Neuropsychology in Primary Care
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract:
The field of neuropsychology is making inroads in primary care as the importance of cognition in physical health is increasingly acknowledged. With neuropsychology primary care integration, patients receive a range of cognitive assessments (e.g., screens, brief neuropsychological assessments, treatment recommendations through provider-to-neuropsychologist consultations) based on a stepped model of care which can more efficiently diagnose cognitive disorders/problems and assist with treatment. Two case studies are described to illuminate this process. Information is provided to illustrate how neuropsychology integration was introduced in two primary care clinics at a community-based hospital system.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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5609
Integration of pediatric mental health care: an evidence-based workshop for primary care providers
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links:
View the DOI record for Integration of pediatric mental health care: an evidence-based workshop for primary care providers
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View the PubMed citation for Integration of pediatric mental health care: an evidence-based workshop for primary care providers5610
Integration of pharmacists into a patient-centered medical home
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: OBJECTIVES: To define the joint principles of the patient-centered medical home (PCMH) and describe the integration of pharmacists into a PCMH. SETTING: Family medicine residency training program in North Carolina from 2001 to 2011. PRACTICE DESCRIPTION: Mountain Area Health Education Family Health Center is a family medicine residency training program that is part of the North Carolina Area Health Education Center system. The goal of the organization is to train and retain health care students and residents. The practice is recognized as a level III PCMH by the National Committee for Quality Assurance (NCQA) and seeks to provide quality, safe, patient-centered care according to the joint principles of PCMH. Pharmacists, nurses, nutritionists, care managers, Spanish translators, and behavioral medicine specialists work collaboratively with physicians to provide seamless, comprehensive care. PRACTICE INNOVATION: The Department of Pharmacotherapy is embedded in the family medicine clinic. Three pharmacists and two pharmacy residents are involved in providing direct patient care services, ensuring access to community resources, assisting patients with transitions of care, providing interprofessional education, and participating in continuous quality improvement initiatives. The pharmacists serve as clinical pharmacist practitioners and provide medication therapy management services in a pharmacotherapy clinic, anticoagulation clinics, and an osteoporosis clinic and via an inpatient family medicine service. Multiple learners such as student pharmacists, pharmacy residents, and family medicine residents rotate through the various pharmacy clinics to learn about pharmacotherapeutic principles and the role of the pharmacist in PCMH. CONCLUSION: PCMH is a comprehensive, patient-centered, team-based approach to population management in the primary care setting. Pharmacists play a vital role in PCMH and make fundamental contributions to patient care across health care settings. Such innovations in the ambulatory care setting create a unique niche for pharmacists to use their skills.
Topic(s):
Education & Workforce
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, Medical Home
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Reference Links:
View the DOI record for Integration of pharmacists into a patient-centered medical home
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View the PubMed citation for Integration of pharmacists into a patient-centered medical home5613
Integration of primary care and behavioral health services in Midwestern community health centers: A mixed methods study
Type: Journal Article
Year: 2022
Topic(s):
General Literature
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Reference Links:
View the DOI record for Integration of primary care and behavioral health services in Midwestern community health centers: A mixed methods study
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View the PubMed citation for Integration of primary care and behavioral health services in Midwestern community health centers: A mixed methods study5616
Integration of primary care into the substance use disorder outpatient treatment setting
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
BACKGROUND: Americans experiencing substance use disorder (SUD) carry a significant chronic disease burden, yet only half use primary care. Patients in treatment for SUD who are connected with primary care typically have better overall health outcomes. LOCAL PROBLEM: The identified intensive outpatient program (IOP) had no protocol in place to engage patients with primary care. METHODS: This project piloted the development and implementation of an original, evidence-based primary care integration program. It consisted of a psychoeducation group, a referral by case management, and establishment of an internal referral process to affiliated primary care providers (PCPs). INTERVENTIONS: Following the psychoeducation group, pre and posttests of patient-reported knowledge and attitudes regarding primary care were compared. Participants were contacted to collect further data after IOP discharge. An education and feedback session was held with affiliated PCPs, and an internal referral process was devised by leadership. RESULTS: Mean scores measuring patient knowledge and attitudes regarding primary care increased after participation in the structured psychoeducation group. By time of IOP discharge, 100% (n = 12) of participants had either a referral or scheduled appointment with a PCP in place. At time of follow-up, 90% (n = 9) reported that they had attended or planned to attend their scheduled PCP appointment. CONCLUSIONS: A comprehensive integration program in the IOP setting can improve patient engagement with primary care. Quality improvement implementation will require consideration of challenges faced during the pilot involving scheduling, staff buy-in, changes in patient acuity, the electronic medical record, and insurance.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Integration of primary care into the substance use disorder outpatient treatment setting
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View the PubMed citation for Integration of primary care into the substance use disorder outpatient treatment setting5617
Integration of primary health services: being put together does not mean they will work together
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: BACKGROUND: This paper reports on an Australian experience of co-locating a range of different primary health services into one building, with the aim of providing integrated services. It discusses some of the early challenges involved with moving services together and reasons why collaborative and integrated working relationships to improve the clients' journey, may remain elusive. METHODS: Ethnographic observational data was collected within a GP plus site as part of day-to-day interactions between the research officer and health professionals. This involved observations of team processes within and across teams at the site. Observations were thematically analysed using a social anthropological approach. RESULTS: Three main themes arose from the analysis: Infrastructural impediments to collaboration; Territorialism; and Interprofessional practice (IPP) simply not on the agenda. The experience of this setting demonstrates that dedicated staff and resources are needed to keep IPP on the agenda of health service organisations. This is especially important where organisations are attempting to implement new models of collaborative and co-located services. Furthermore, it shows that establishing IPP within newly co-located services is a process that needs time to develop, as part of teams building trust with each other in new circumstances, in order to eventually build a new cultural identity for the co-located services. CONCLUSIONS: Co-located health service systems can be complex, with competing priorities and differing strategic plans and performance indicators to meet. This, coupled with the tendency for policy makers to move on to their next issue of focus, and to shift resources in the process, means that adequate time and resources for IPP are often overlooked. Shared interprofessional student placements may be one way forward.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Integration of primary health services: being put together does not mean they will work together
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View the PubMed citation for Integration of primary health services: being put together does not mean they will work together5619
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: An evaluation in three pilot sites
Type: Journal Article
Year: 2019
Publication Place: Ireland
Topic(s):
Opioids & Substance Use
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5620
Integration of substance use disorder services with primary care: health center surveys and qualitative interviews
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: BACKGROUND: Each year, nearly 20 million Americans with alcohol or illicit drug dependence do not receive treatment. The Affordable Care Act and parity laws are expected to result in increased access to treatment through integration of substance use disorder (SUD) services with primary care. However, relatively little research exists on the integration of SUD services into primary care settings. Our goal was to assess SUD service integration in California primary care settings and to identify the practice and policy facilitators and barriers encountered by providers who have attempted to integrate these services. METHODS: Primary survey and qualitative interview data were collected from the population of federally qualified health centers (FQHCs) in five California counties known to be engaged in SUD integration efforts was surveyed. From among the organizations that responded to the survey (78% response rate), four were purposively sampled based on their level of integration. Interviews were conducted with management, staff, and patients (n = 18) from these organizations to collect further qualitative information on the barriers and facilitators of integration. RESULTS: Compared to mental health services, there was a trend for SUD services to be less integrated with primary care, and SUD services were rated significantly less effective. The perceived difference in effectiveness appeared to be due to provider training. Policy suggestions included expanding the SUD workforce that can bill Medicaid, allowing same-day billing of two services, facilitating easier reimbursement for medications, developing the workforce, and increasing community SUD specialty care capacity. CONCLUSIONS: Efforts to integrate SUD services with primary care face significant barriers, many of which arise at the policy level and are addressable.
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for Integration of substance use disorder services with primary care: health center surveys and qualitative interviews
View DOI Record
View the PubMed citation for Integration of substance use disorder services with primary care: health center surveys and qualitative interviews